MEDICARE: THERESE MARIE STEINMETZ MSN, PNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	71002075A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417923756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESE MARIE STEINMETZ MSN, PNP

Provider Business Mailing Address
First Line	:	3355 DOUGLAS RD
Second Line	:	SUITE 300
City	:	SOUTH BEND
State	:	IN
Zip	:	46635-1781
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 NAVARRE PL
Second Line	:	SUITE 4440
City	:	SOUTH BEND
State	:	IN
Zip	:	46601-1156
Country	:	US
Telephone Number	:	574-647-4540
Fax Number	:	574-647-4542

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	02/10/2009

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